Last Modified: 6/21/2017
Location: FL, PR, USVI
Business: Part A, Part B
Provider enrollment mailing address
Q: Where do I mail my provider enrollment application?
A: You may mail your completed paper application to your assigned Medicare administrative contractor (MAC). First Coast Service Options Inc. (First Coast) is the MAC assigned to jurisdiction N (JN), which encompasses Florida, Puerto Rico, and the U.S. Virgin Islands. If you are located within JN, please mail your completed provider enrollment application to the following address:
Provider Enrollment
P.O. Box 44021
Jacksonville, FL 32231-4021
P.O. Box 44021
Jacksonville, FL 32231-4021
Access the Provider Enrollment Application Assistance Tool for more help in determining the appropriate enrollment form for submission.
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